Skip to main content
Top
Published in: Obesity Surgery 6/2021

01-06-2021 | Obesity | Original Contributions

Laparoscopic Roux-en-Y Gastric Bypass and Laparoscopic Sleeve Gastrectomy in Terms of Efficacy and Safety: a Comparative Study During 11-Year Experience

Authors: Karamollah Toolabi, Mahdieh Golzarand, Roya Farid

Published in: Obesity Surgery | Issue 6/2021

Login to get access

Abstract

Purpose

This cohort study was designed to compare the efficacy and safety of laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) for the management of morbid obesity during the 11-year experience.

Materials and Methods

This study was conducted between July 2006 and August 2019. Annually we recorded data about the weight, body mass index (BMI), percentage of excess weight loss (%EWL), percentage of weight loss (%WL), weight regain, and postoperative complications into a prospectively collected database.

Results

A total of 1146 patients (LRYGB=396 and LSG=750) aged >18 years old were included in the study. Over the first 7 years after surgery, the weight loss rate was significantly higher in the LRYGB-treated group than the LSG-treated group, and weight regain was significantly lower in the LRYGB-treated group in comparison with the LSG-treated group. Our results revealed that statistically, but not clinically, the efficacy of LRYGB and LSG is equivalent in terms of %WL, %EWL, and weight regain within 8 years and more. Besides, there were no significant differences in surgery-related mortality and severe complications between the two procedures.

Conclusion

Our study’s results indicated that the clinical efficacy of LRYGB in the management of obesity is better than LSG during the 11-year experience. But the differences in weight loss and weight regain were not statistically relevant at 8 years and more after the surgery. Also, a comparison of severe complications did not indicate significant differences between the two groups.
Literature
1.
go back to reference Zhang S, de la Haye K, Ji M, et al. Applications of social network analysis to obesity: a systematic review. Obes Rev. 2018;19(7):976–88.PubMedCrossRef Zhang S, de la Haye K, Ji M, et al. Applications of social network analysis to obesity: a systematic review. Obes Rev. 2018;19(7):976–88.PubMedCrossRef
2.
go back to reference Lung T, Jan S, Tan EJ, et al. Impact of overweight, obesity and severe obesity on life expectancy of Australian adults. Int J Obes (Lond). 2019;43(4):782–9.CrossRef Lung T, Jan S, Tan EJ, et al. Impact of overweight, obesity and severe obesity on life expectancy of Australian adults. Int J Obes (Lond). 2019;43(4):782–9.CrossRef
3.
go back to reference Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627-42. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627-42.
4.
go back to reference Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25(10):1822–32.PubMedCrossRef Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25(10):1822–32.PubMedCrossRef
5.
go back to reference Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery and endoluminal procedures: IFSO worldwide survey 2014. Obes Surg. 2017;27(9):2279–89.PubMedPubMedCentralCrossRef Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery and endoluminal procedures: IFSO worldwide survey 2014. Obes Surg. 2017;27(9):2279–89.PubMedPubMedCentralCrossRef
6.
go back to reference Duvoisin C, Favre L, Allemann P, et al. Roux-en-Y gastric bypass: ten-year results in a cohort of 658 patients. Ann Surg. 2018;268(6):1019–25.PubMedCrossRef Duvoisin C, Favre L, Allemann P, et al. Roux-en-Y gastric bypass: ten-year results in a cohort of 658 patients. Ann Surg. 2018;268(6):1019–25.PubMedCrossRef
7.
go back to reference Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.PubMedPubMedCentralCrossRef Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.PubMedPubMedCentralCrossRef
8.
go back to reference Bhandari M, Reddy M, Kosta S, et al. Laparoscopic sleeve gastrectomy versus laparoscopic gastric bypass: a retrospective cohort study. Int J Surg. 2019;67:47–53.PubMedCrossRef Bhandari M, Reddy M, Kosta S, et al. Laparoscopic sleeve gastrectomy versus laparoscopic gastric bypass: a retrospective cohort study. Int J Surg. 2019;67:47–53.PubMedCrossRef
9.
go back to reference Guraya SY, Strate T. Effectiveness of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy for morbid obesity in achieving weight loss outcomes. Int J Surg. 2019;70:35–43.PubMedCrossRef Guraya SY, Strate T. Effectiveness of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy for morbid obesity in achieving weight loss outcomes. Int J Surg. 2019;70:35–43.PubMedCrossRef
10.
go back to reference Pekkarinen T, Mustonen H, Sane T, et al. Long-term effect of gastric bypass and sleeve gastrectomy on severe obesity: do preoperative weight loss and binge eating behavior predict the outcome of bariatric surgery? Obes Surg. 2016;26(9):2161–7.PubMedCrossRef Pekkarinen T, Mustonen H, Sane T, et al. Long-term effect of gastric bypass and sleeve gastrectomy on severe obesity: do preoperative weight loss and binge eating behavior predict the outcome of bariatric surgery? Obes Surg. 2016;26(9):2161–7.PubMedCrossRef
11.
go back to reference Perrone F, Bianciardi E, Ippoliti S, et al. Long-term effects of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass for the treatment of morbid obesity: a monocentric prospective study with minimum follow-up of 5 years. Updates Surg. 2017;69(1):101–7.PubMedCrossRef Perrone F, Bianciardi E, Ippoliti S, et al. Long-term effects of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass for the treatment of morbid obesity: a monocentric prospective study with minimum follow-up of 5 years. Updates Surg. 2017;69(1):101–7.PubMedCrossRef
12.
go back to reference van de Laar AW, Nienhuijs SW, Apers JA, et al. The Dutch bariatric weight loss chart: a multicenter tool to assess weight outcome up to 7 years after sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2019;15(2):200–10.PubMedCrossRef van de Laar AW, Nienhuijs SW, Apers JA, et al. The Dutch bariatric weight loss chart: a multicenter tool to assess weight outcome up to 7 years after sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2019;15(2):200–10.PubMedCrossRef
13.
go back to reference Zhang Y, Zhao H, Cao Z, et al. A randomized clinical trial of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy for the treatment of morbid obesity in China: a 5-year outcome. Obes Surg. 2014;24(10):1617–24.PubMedCrossRef Zhang Y, Zhao H, Cao Z, et al. A randomized clinical trial of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy for the treatment of morbid obesity in China: a 5-year outcome. Obes Surg. 2014;24(10):1617–24.PubMedCrossRef
14.
go back to reference Ahmed B, King WC, Gourash W, et al. Long-term weight change and health outcomes for sleeve gastrectomy (SG) and matched Roux-en-Y gastric bypass (RYGB) participants in the Longitudinal Assessment of Bariatric Surgery (LABS) study. Surgery. 2018;164:774–83.PubMedPubMedCentralCrossRef Ahmed B, King WC, Gourash W, et al. Long-term weight change and health outcomes for sleeve gastrectomy (SG) and matched Roux-en-Y gastric bypass (RYGB) participants in the Longitudinal Assessment of Bariatric Surgery (LABS) study. Surgery. 2018;164:774–83.PubMedPubMedCentralCrossRef
15.
go back to reference Yang P, Chen B, Xiang S, et al. Long-term outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass for morbid obesity: results from a meta-analysis of randomized controlled trials. Surg Obes Relat Dis. 2019;15(4):546–55.PubMedCrossRef Yang P, Chen B, Xiang S, et al. Long-term outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass for morbid obesity: results from a meta-analysis of randomized controlled trials. Surg Obes Relat Dis. 2019;15(4):546–55.PubMedCrossRef
16.
go back to reference Shoar S, Saber AA. Long-term and midterm outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass: a systematic review and meta-analysis of comparative studies. Surg Obes Relat Dis. 2017;13(2):170–80.PubMedCrossRef Shoar S, Saber AA. Long-term and midterm outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass: a systematic review and meta-analysis of comparative studies. Surg Obes Relat Dis. 2017;13(2):170–80.PubMedCrossRef
17.
18.
go back to reference Artero A, Martinez-Ibanez J, Civera M, et al. Anthropometric parameters and permanent remission of comorbidities 10 years after open gastric bypass in a cohort with high prevalence of super-obesity. Endocrinol Diabetes Nutr. 2017;64(6):310–6.PubMedCrossRef Artero A, Martinez-Ibanez J, Civera M, et al. Anthropometric parameters and permanent remission of comorbidities 10 years after open gastric bypass in a cohort with high prevalence of super-obesity. Endocrinol Diabetes Nutr. 2017;64(6):310–6.PubMedCrossRef
19.
go back to reference Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734–40.PubMedPubMedCentralCrossRef Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734–40.PubMedPubMedCentralCrossRef
20.
go back to reference Higa K, Ho T, Tercero F, et al. Laparoscopic Roux-en-Y gastric bypass: 10-year follow-up. Surg Obes Relat Dis. 2011;7(4):516–25.PubMedCrossRef Higa K, Ho T, Tercero F, et al. Laparoscopic Roux-en-Y gastric bypass: 10-year follow-up. Surg Obes Relat Dis. 2011;7(4):516–25.PubMedCrossRef
21.
go back to reference Kothari SN, Borgert AJ, Kallies KJ, et al. Long-term (>10-year) outcomes after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2017;13(6):972–8.PubMedCrossRef Kothari SN, Borgert AJ, Kallies KJ, et al. Long-term (>10-year) outcomes after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2017;13(6):972–8.PubMedCrossRef
22.
go back to reference Mehaffey JH, LaPar DJ, Clement KC, et al. 10-year outcomes after Roux-en-Y gastric bypass. Ann Surg. 2016;264(1):121–6.PubMedCrossRef Mehaffey JH, LaPar DJ, Clement KC, et al. 10-year outcomes after Roux-en-Y gastric bypass. Ann Surg. 2016;264(1):121–6.PubMedCrossRef
23.
go back to reference Monaco-Ferreira DV, Leandro-Merhi VA. Weight regain 10 years after Roux-en-Y gastric bypass. Obes Surg. 2017;27(5):1137–44.PubMedCrossRef Monaco-Ferreira DV, Leandro-Merhi VA. Weight regain 10 years after Roux-en-Y gastric bypass. Obes Surg. 2017;27(5):1137–44.PubMedCrossRef
24.
go back to reference Nguyen NT, Kim E, Vu S, et al. Ten-year outcomes of a prospective randomized trial of laparoscopic gastric bypass versus laparoscopic gastric banding. Ann Surg. 2018;268(1):106–13.PubMedPubMedCentralCrossRef Nguyen NT, Kim E, Vu S, et al. Ten-year outcomes of a prospective randomized trial of laparoscopic gastric bypass versus laparoscopic gastric banding. Ann Surg. 2018;268(1):106–13.PubMedPubMedCentralCrossRef
25.
go back to reference Obeid NR, Malick W, Concors SJ, et al. Long-term outcomes after Roux-en-Y gastric bypass: 10- to 13-year data. Surg Obes Relat Dis. 2016;12(1):11–20.PubMedCrossRef Obeid NR, Malick W, Concors SJ, et al. Long-term outcomes after Roux-en-Y gastric bypass: 10- to 13-year data. Surg Obes Relat Dis. 2016;12(1):11–20.PubMedCrossRef
26.
go back to reference Sugerman HJ, Wolfe LG, Sica DA, et al. Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss. Ann Surg. 2003;237(6):751–8.PubMedPubMedCentral Sugerman HJ, Wolfe LG, Sica DA, et al. Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss. Ann Surg. 2003;237(6):751–8.PubMedPubMedCentral
27.
go back to reference Valezi AC, de Almeida MM, Mali Jr J. Weight loss outcome after Roux-en-Y gastric bypass: 10 years of follow-up. Obes Surg. 2013;23(8):1290–3.PubMedCrossRef Valezi AC, de Almeida MM, Mali Jr J. Weight loss outcome after Roux-en-Y gastric bypass: 10 years of follow-up. Obes Surg. 2013;23(8):1290–3.PubMedCrossRef
28.
go back to reference Sjostrom L, Lindroos A, Peltonen M, et al. Life style, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;352:2683–93.CrossRef Sjostrom L, Lindroos A, Peltonen M, et al. Life style, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;352:2683–93.CrossRef
29.
go back to reference Spivak H, Abdelmelek MF, Beltran OR, et al. Long-term outcomes of laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass in the United States. Surg Endosc. 2012;26(7):1909–19.PubMedCrossRef Spivak H, Abdelmelek MF, Beltran OR, et al. Long-term outcomes of laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass in the United States. Surg Endosc. 2012;26(7):1909–19.PubMedCrossRef
30.
go back to reference Edholm D, Svensson F, Naslund I, et al. Long-term results 11 years after primary gastric bypass in 384 patients. Surg Obes Relat Dis. 2013;9(5):708–13.PubMedCrossRef Edholm D, Svensson F, Naslund I, et al. Long-term results 11 years after primary gastric bypass in 384 patients. Surg Obes Relat Dis. 2013;9(5):708–13.PubMedCrossRef
31.
go back to reference Arman GA, Himpens J, Dhaenens J, et al. Long-term (11+years) outcomes in weight, patient satisfaction, comorbidities, and gastroesophageal reflux treatment after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2016;12(10):1778–86.PubMedCrossRef Arman GA, Himpens J, Dhaenens J, et al. Long-term (11+years) outcomes in weight, patient satisfaction, comorbidities, and gastroesophageal reflux treatment after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2016;12(10):1778–86.PubMedCrossRef
32.
go back to reference Castagneto Gissey L, Casella Mariolo JR, Genco A, et al. 10-year follow-up after laparoscopic sleeve gastrectomy: outcomes in a monocentric series. Surg Obes Relat Dis. 2018;14(10):1480–7.PubMedCrossRef Castagneto Gissey L, Casella Mariolo JR, Genco A, et al. 10-year follow-up after laparoscopic sleeve gastrectomy: outcomes in a monocentric series. Surg Obes Relat Dis. 2018;14(10):1480–7.PubMedCrossRef
33.
go back to reference Chang DM, Lee WJ, Chen JC, et al. Thirteen-year experience of laparoscopic sleeve gastrectomy: surgical risk, weight loss, and revision procedures. Obes Surg. 2018;28(10):2991–7.PubMedCrossRef Chang DM, Lee WJ, Chen JC, et al. Thirteen-year experience of laparoscopic sleeve gastrectomy: surgical risk, weight loss, and revision procedures. Obes Surg. 2018;28(10):2991–7.PubMedCrossRef
34.
go back to reference Felsenreich DM, Langer FB, Kefurt R, et al. Weight loss, weight regain, and conversions to Roux-en-Y gastric bypass: 10-year results of laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2016;12(9):1655–62.PubMedCrossRef Felsenreich DM, Langer FB, Kefurt R, et al. Weight loss, weight regain, and conversions to Roux-en-Y gastric bypass: 10-year results of laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2016;12(9):1655–62.PubMedCrossRef
35.
go back to reference Bruschi Kelles SM, Diniz MF, Machado CJ, et al. Mortality rate after open Roux-in-Y gastric bypass: a 10-year follow-up. Braz J Med Biol Res. 2014;47(7):617–25.PubMedPubMedCentralCrossRef Bruschi Kelles SM, Diniz MF, Machado CJ, et al. Mortality rate after open Roux-in-Y gastric bypass: a 10-year follow-up. Braz J Med Biol Res. 2014;47(7):617–25.PubMedPubMedCentralCrossRef
36.
go back to reference Thereaux J, Lesuffleur T, Czernichow S, et al. Long-term adverse events after sleeve gastrectomy or gastric bypass: a 7-year nationwide, observational, population-based, cohort study. Lancet Diabetes Endocrinol. 2019;7(10):786–95.PubMedCrossRef Thereaux J, Lesuffleur T, Czernichow S, et al. Long-term adverse events after sleeve gastrectomy or gastric bypass: a 7-year nationwide, observational, population-based, cohort study. Lancet Diabetes Endocrinol. 2019;7(10):786–95.PubMedCrossRef
37.
go back to reference Shah K, Nergard BJ, Frazier KS, et al. Long-term effects of laparoscopic Roux-en-Y gastric bypass on metabolic syndrome in patients with morbid obesity. Surg Obes Relat Dis. 2016;12:1449–56.PubMedCrossRef Shah K, Nergard BJ, Frazier KS, et al. Long-term effects of laparoscopic Roux-en-Y gastric bypass on metabolic syndrome in patients with morbid obesity. Surg Obes Relat Dis. 2016;12:1449–56.PubMedCrossRef
38.
go back to reference Frattini F. delpini R, Inversini D, et al. Gastric leaks after sleeve gastrectomy: focus on pathogenetic factors. Surg Technol Int. 2017;31:123–6.PubMed Frattini F. delpini R, Inversini D, et al. Gastric leaks after sleeve gastrectomy: focus on pathogenetic factors. Surg Technol Int. 2017;31:123–6.PubMed
39.
go back to reference Miyamoto S, Nakao J, Higashino T, et al. Clavien-Dindo classification for grading complications after total pharyngolaryngectomy and free jejunum transfer. PLoS One. 2019;14(9):e0222570.PubMedPubMedCentralCrossRef Miyamoto S, Nakao J, Higashino T, et al. Clavien-Dindo classification for grading complications after total pharyngolaryngectomy and free jejunum transfer. PLoS One. 2019;14(9):e0222570.PubMedPubMedCentralCrossRef
Metadata
Title
Laparoscopic Roux-en-Y Gastric Bypass and Laparoscopic Sleeve Gastrectomy in Terms of Efficacy and Safety: a Comparative Study During 11-Year Experience
Authors
Karamollah Toolabi
Mahdieh Golzarand
Roya Farid
Publication date
01-06-2021
Publisher
Springer US
Published in
Obesity Surgery / Issue 6/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-021-05313-0

Other articles of this Issue 6/2021

Obesity Surgery 6/2021 Go to the issue